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Title: A study of the effects of analgesia in acute and chronic pain in preterm infants
Author: Boyle, Elaine M.
Awarding Body: University of Edinburgh
Current Institution: University of Edinburgh
Date of Award: 2004
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Pain assessment is the key to pain management. Self-report of pain is the gold standard for pain assessment in older age groups, but in the preverbal infant this is obviously not available. A simple and accurate means of identifying and measuring pain would enable appropriate initiation of analgesia and evaluation of its effects. There are no recognised physiological or behavioural indicators that can be used to assist with the detection and assessment of chronic pain in infants whether or not they are undergoing neonatal intensive care, but there are situations in the neonatal intensive care unit in which one could anticipate that infants would experience chronic pain. This study investigates mean heart rate, heart rate variability and the cutaneous flexor withdrawal reflex as potential indicators of chronic or acute pain in preterm infants. The relationship between mean heart rate, heart rate variability, pain and analgesia is explored in two different situations: 1. In preterm infants undergoing chronic pain or distress associated with mechanical ventilation, randomised to receive morphine or placebo. The groups are compared to assess whether mean heart rate, heart rate variability or the cutaneous flexor withdrawal reflex threshold are useful in the assessment of pain or withdrawal of opiate analgesia in the clinical situation. 2. In infants undergoing the acute pain and stress of ophthalmological examination for screening for retinopathy of prematurity. These infants were randomised to receive sucrose solution or placebo. These groups are similarly compared to assess whether mean heart rate or heart rate variability are useful for pain assessment.
Supervisor: Not available Sponsor: Not available
Qualification Name: Thesis (M.D.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available